Active NPI
Diana Borromeo
- Marriage & Family Therapist
- San Mateo, CA
National Provider Identifier
1093462384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 142068
- Practice address
- 1510 Fashion Island Blvd Ste 110
San Mateo, CA 94404-5043 - Phone
- (415) 964-7690
- NPI assigned
- Mar 7, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 14901 | CA | |
| Marriage & Family Therapist | 106H00000X | 142068 | CA | Primary |
Addresses
Primary practice location
1510 Fashion Island Blvd Ste 110
San Mateo, CA 94404-5043
Mailing address
1510 Fashion Island Blvd Ste 110
San Mateo, CA 94404-5043
Phone (415) 964-7690
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BACB765676 | Other | CA | BACB ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 142068 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698192000000",
"number": "1093462384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1510 FASHION ISLAND BLVD STE 110",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944045043",
"telephone_number": "415-964-7690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1510 FASHION ISLAND BLVD STE 110",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944045043",
"telephone_number": "415-964-7690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORROMEO",
"first_name": "DIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-07",
"last_updated": "2023-10-25",
"certification_date": "2023-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "14901",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "142068",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BACB ID",
"identifier": "BACB765676",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.